Trial reportBMJ open2026
Developing Hospital at Home tariffs in Denmark: a time-driven activity-based microcosting approach within a randomised controlled trial.
Trial report in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05360914 (Improving and Evaluation of a New Cross-sectoral Hospital at Home Model for Elderly Acute Ill Patients), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Improving and Evaluation of a New Cross-sectoral Hospital at Home Model for Elderly Acute Ill Patients
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo develop an empirically grounded, activity-based tariff framework for Hospital at Home (HaH) services using time-driven activity-based costing (TDABC) and micro-costing to support transparent and equitable reimbursement for acute elderly care delivered at home.
designMicrocosting study embedded within a randomised controlled trial (RCT) comparing HaH with conventional hospital admission in Denmark.
settingThree municipalities in the Central Denmark Region in collaboration with emergency department physicians at a regional hospital.
participantsA consecutive subsample of 107 elderly acute patients enrolled in the RCT between June 2022 and February 2024. Resource use for HaH activities was measured prospectively using microcosting logs, time-motion observations and administrative records.
main outcome measuresEmpirically derived tariffs per HaH visit (first and subsequent) calculated using an eight-step TDABC framework incorporating process mapping, resource identification, capacity cost rates and time equations. Sensitivity analyses tested robustness to variation in key cost drivers.
resultsThe mean total tariff was €338.89 (95% CI €310.94 to €351.49) for first visits and €207.81 (95% CI €200.70 to €215.69) for subsequent visits, including treatment and transport components. Staff time was the principal cost driver, while equipment, overhead and travel reimbursement had smaller effects. The framework accommodates variation in staffing, geography and visit intensity and can be used to estimate total costs across diverse HaH pathways.
conclusionsA transparent and reproducible tariff-development framework for HaH services was established using TDABC and microcosting. The model aligns reimbursement with actual resource use and care complexity and provides a transferable template for economic evaluation and operational planning. TRIAL REGISTRATION NUMBER: NCT05360914.
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